This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Thursday, December 05, 2013

Australian Telehealth Gets A Couple Of Discussions and Reviews. Well Worth A Browse.

FROM a smartphone app that scans your vital signs to doctors treating their far distant patients through "face time" on their tablets or computers, technology is changing the way thousands of Australians access health care.

General Practitioner Ashley Collins is stationed more than 1000 kilometres from his patient but he can get a blood pressure reading without laying a hand on the company director.

Using a video link and a portable machine owned by the patient he can measure blood glucose, pulse rate, body temperature, cholesterol and even get an ECG measurement.

When he's completed his diagnosis he faxes a script to the chemist nearest his patient.

Dr Collins, from Temorah in central western NSW, uses a specialised computer to deliver this care but from next year he says patients will be able to do this from their mobile phone.

Already there are new devices including ultrasounds, ECG monitors, mirocroscopes and dermatascopes that can view skin cancers and blood pressure monitors that can be plugged into a smartphone.

A picture of an inner ear or throat taken on a smart phone can help a doctor diagnose and infection.

One app even allows you to scan your vital signs just by placing the phone on your forehead to measure heart rate, and body temperature.

Telemedicine Australia GP Dr Collins is part of a network of 15 general practitioners and 270 specialists providing telemedicine to thousands of patients around Australia.

There is no Medicare rebate for the GP service he provides at a cost of $50 a session, a problem he thinks Medicare and health funds should remedy.

Australia will spend over $10 trillion on healthcare over the next thirty years - much of it on aged care. If the new NBN-related health applications make a tiny dent in that figure, they would pay for the whole NBN. And revolutionise healthcare for all.

In the toxic fact-free zone that represents the bulk of National Broadband Network discussion, most people would be shocked to know that the NBN is likely worth building for the healthcare benefits alone - especially for the old and infirm. And the NBN doesn't just offer a healthcare revolution, it's likely to save tax payers billions of dollars every year. Most important of all, however, is the notion that these new-generation 'Telehealthcare' applications are only viable using the current Fibre to the Home broadband policy and not the Coalition's alternative. Could it be that convalescing old ladies, who have never used a computer in their lives, are the pin-up girls for fibre-based broadband?

Meaningless phrases and numbers

Many people are sick of hearing nebulous terms like 'superfast broadband' and jargon like 'jigabits per second' and 'download speeds.'

Telehealthcare ignores all of that and treats the NBN like the infrastructure that it is - a network which provides a medical-grade, reliable connection to each home and a complete standardisation of equipment - i.e. 'one box and one interface for everyone' - instead of the hotchpotch, 'every-situation-is-different' situation that we have today.

At the time we released the 2007 South Australian Health Care Plan, if SA Health had continued spending at the same rate, then by 2032 the entire State budget will be consumed by Health alone. Our efforts to reduce growth in demand has now pushed this back to 2038. Slowing the growth in demand, however, must be accompanied by providing more efficient services in order to deliver a balanced budget...

Peter Croft from Allocate (healthcare) Software adds, "Most State governments have identified a point in the future where the growth in funding for health is going to consume the entire state budget."

The problem is that improvements have to come from efficiency gains and not spending cuts. As Stephen Duckett and Cassie McGannon said recently in The Conversation:

Reducing health spending growth will not be easy. As Grattan's Game-changers report last year showed, Australia already has one of the OECD's most efficient health systems, in terms of life expectancy achieved for dollars spent. Sweeping cuts to health funding, or shifting costs to consumers, could have serious consequences. Blunt cost-cutting risks reducing health and well-being, and could ultimately lead to higher government costs due to illness, increased health-care needs and lower workforce participation.

1 comment:

David, I have tried to address some of the cost generators and possible foci for designing solutions in my recent article, Hannan TJ, Celia C. Are doctors the structural weakness in the e-health building? Intern Med J. 2013;43(10):1155-64. Epub 2013/10/19.Also Dr J Wennberg has produced some wonderful work on costs and access out of the Dartmouth Institute in North America that are applicable to many health domains not just the USA. If the decision makers in Canberra do not or will not involve those who may be able to help as has happened with the PCEHR maybe they should extend their knowledge bases by reading more widely.http://patients.dartmouth-hitchcock.org/shared_decision_making.html